Modification of Goal-directed and Habitual Behavior in Addiction

Central Institute of Mental Health, Mannheim

Status: Completed

Conditions: Tobacco Use Disorder

Treatments: Behavioral: standard smoking cessation program (SCP); Behavioral: Implicit computer-based habit-modifying training (ICHT); Behavioral: Cognitive remediation treatment (CRT)

Study type: Interventional

Funder types: Other

Identifiers

NCT03764969

TRR265 C01

Details and patient eligibility

About

This study aims to examine the modification of the hypothesized imbalance between goal-directed and habitual behavior and its neural correlates in smokers. Two interventions will be used as add-on trainings to a smoking cessation program.

Full description

In this study, the investigators aim to assess the imbalance between goal-directed and habitual behavior, its neural basis and how it can be differentially modified in treatment-seeking smokers, using two training interventions. The first intervention is cognitive remediation treatment (CRT), also known as cognitive enhancement therapy, focusing on improving inhibitory control and executive functions. The second intervention, a computer-based habit-modifying training focusing on implicit drug seeking ("implicit computer-based habit-modifying training", ICHT) uses a conditioning approach through implicit priming and contextual modulation. Indicators of the imbalance will be examined with respect to reward devaluation, cue reactivity and a pavlovian instrumental transfer (PIT) paradigm. The investigators hypothesize that both interventions change the balance between goal-directed and habitual behavior but by different mechanisms. Whereas CRT should directly increase cognitive control, in contrast, ICHT should affect the early processing and the emotional valence of smoking and smoking cues.

Enrollment: 75 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• severe tobacco use disorder (TUD) according to DSM-5
• sufficient ability to communicate with investigators and answer questions in both written and verbal format
• ability to provide fully informed consent and to use self-rating scales

Exclusion criteria

• severe internal, neurological, and/or psychiatric comorbidities; other Axis I mental disorders other than TUD according to ICD-10 and DSM 5 (except for mild depression, i.e. F32.0, adjustment disorder and specific phobias) in the last 12 months
• history of brain injury
• severe physical diseases
• common exclusion criteria for MRI (e.g. metal, claustrophobia)
• positive drug screening (opioids, benzodiazepines, barbiturates, cocaine, amphetamines)
• psychotropic medication within the last 14 days
• pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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75 participants in 3 patient groups

standard smoking cessation program (SCP)

Active Comparator group

Description:

standard smoking cessation program

Treatment:

Behavioral: standard smoking cessation program (SCP)

SCP + CRT

Experimental group

Description:

SCP plus cognitive remediation treatment (CRT)

Treatment:

Behavioral: Cognitive remediation treatment (CRT)

Behavioral: standard smoking cessation program (SCP)

SCP + ICHT

Experimental group

Description:

SCP plus an implicit computer-based habit-modifying training (ICHT)

Treatment:

Behavioral: Implicit computer-based habit-modifying training (ICHT)

Behavioral: standard smoking cessation program (SCP)